Abstract

The world health report 2006: working together for health has brought renewed attention to the global human resources required to produce health.1 It estimated that 57 countries have an absolute shortage of 2.3 million physicians, nurses and midwives. These shortages suggest that many countries have insufficient numbers of health professionals to deliver essential health interventions, such as skilled attendance at birth and immunization programmes. However, these estimates do not take into account the ability of countries to recruit and retain these workers, nor are they specific enough to inform policy-makers about how, and to what extent, health workforce investment should be channelled into training of different professions.

This paper focuses on physicians, who serve a key role in health-care provision. Using the most updated information on the supply of physicians over a 20-year period, we project the size of the future global need for, demand for and supply of physicians to year 2015, the target date for the Millennium Development Goals (MDGs).2 Needs-based estimates use an exogenous health benchmark to judge the adequacy of the number of physicians required to meet MDG targets. Demand estimates are based on a country’s economic growth and the increase in health-care spending that results from it, which primarily goes towards worker salaries. We then compare the needs-based and demand-based estimates to the projected supply of physicians, extrapolated based on historical trends. Our results point to dramatic shortages of physicians in the WHO African Region by 2015. We provide estimates of shortages by country in Africa and discuss their implications for different workforce policy choices.